Analysis of pathogen distribution and drug resistance in COPD patients with pulmonary tuberculosis at Kuqa second people's hospital
库车市第二人民医院慢阻肺合并肺结核患者的病原菌分布及耐药性分析

摘要

目的 探讨慢阻肺合并肺结核患者病原菌分布特征及耐药性情况，为临床合理选用抗菌药物提供依据。方法 回顾性选取我院收治的525例慢阻肺合并肺结核患者的病原菌检测及耐药性数据，时间区间为2024年1月至12月，经χ²检验及SPSS18软件；结果 共分离出45种细菌，排名前三位的病原菌为肺炎克雷伯菌（158株，30%）、洋葱伯克霍尔德菌（68株，13%）、鲍曼不动杆菌（55株，10%）。耐药性分析显示，肺炎克雷伯菌对美罗培南（98.1%）、阿米卡星（98.7%）敏感性高，对头孢唑林（73.4%）敏感性较低；洋葱伯克霍尔德菌对头孢他叮（91.2%）、美罗培南（88.2%）敏感性较高，对左氧氟沙星（30.9%）、氯霉素（40.9%）敏感性低；鲍曼不动杆菌对粘菌素（94.5%）、庆大霉素（87.3%）敏感性较好，对头孢曲松（1.82%）敏感性极低。结论 慢阻肺合并肺结核患者病原菌以肺炎克雷伯菌、洋葱伯克霍尔德菌、鲍曼不动杆菌为主，不同性别、年龄分布无显著差异。针对慢阻肺合并肺结核患者，一些菌株有较强敏感性，经临床上的药敏结果分析和病原学分检测，对合理选择抗生素，明确致病菌和减少耐药菌株取得的作用显著，具有临床应用价值。

Abstract

Objective To investigate the distribution characteristics and drug resistance of pathogens in patients with chronic obstructive pulmonary disease (COPD) combined with pulmonary tuberculosis, providing a basis for the rational selection of antimicrobial agents in clinical practice.
Methods A retrospective study was conducted on 525 patients with COPD combined with pulmonary tuberculosis admitted to our hospital from January to December 2024. Pathogen detection and drug resistance data were analyzed using the χ² test and SPSS18 software.
Results A total of 45 bacterial species were isolated, with the top three pathogens being Klebsiella pneumoniae (158 strains, 30%), Burkholderia cepacia (68 strains, 13%), and Acinetobacter baumannii (55 strains, 10%). Drug susceptibility analysis showed that Klebsiella pneumoniae was highly sensitive to meropenem (98.1%) and amikacin (98.7%), but less sensitive to cefazolin (73.4%); Burkholderia cepacia showed high sensitivity to cefotetan (91.2%) and meropenem (88.2%), but low sensitivity to levofloxacin (30.9%) and chloramphenicol (40.9%); Acinetobacter baumannii exhibited good sensitivity to polymyxin (94.5%) and gentamicin (87.3%), but extremely low sensitivity to ceftriaxone (1.82%).
Conclusion   In patients with COPD combined with pulmonary tuberculosis, the predominant pathogens are Klebsiella pneumoniae, Burkholderia cepacia, and Acinetobacter baumannii, with no significant differences in gender or age distribution. For these patients, certain bacterial strains show high sensitivity, and clinical drug susceptibility analysis along with pathogen identification can significantly help in the rational selection of antibiotics, clarify the causative pathogens, and reduce the emergence of resistant strains, offering valuable clinical implications.